Application Form For Admission In To First Year Of B.tech. / Mba Degree Course Page 2
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5JNTUH H.T.No.
K K K K K OMMURI PRA
OMMURI PRA
OMMURI PRA
OMMURI PRAT T T T T AP REDD
AP REDD
AP REDD
Y INSTITUTE OF
Y INSTITUTE OF
TECHNOL
TECHNOL
OGY
OGY
OMMURI PRA
AP REDD
AP REDDY INSTITUTE OF
Y INSTITUTE OF
Y INSTITUTE OF TECHNOL
TECHNOL
TECHNOLOGY
OGY
OGY
(Approved by AICTE, New Delhi and Affiliated to JNTUH, Hyderabad)
Near Singapore Township, Adjacent to NTPC Power Grid, Ghanpur Gram Panchayat,
Ghatkesar, Ranga Reddy Dist. 500 088. e-mail : info@kpritech.ac.in,
Admn.Office : Sai Pragathi Towers, 3-6-519, Opp. KFC, Himayathnagar, Hyderabad.
1. Name of the candidate_____________________________________________________
( As per SSC )
Affix your latest
2. Gender______________ 3. Date of Birth _______________4. Caste_______________
passport size
photograph
6. Religion ________________ Annual Income __________________________________
5. e-mail _______________________________________Mobile No. (Student) ________________________
7. Programme: B.Tech. / MBA / M.Tech. 8. Course ________________ 9. Level : PG / UG
10. Date of Joining ______________11. Admitted to : Convenor/Management 12. Roll No. ________________
13. SSC H.T.No. _________________________ 14. SSC % ______________ 15. Year of Pass ___________
14. Intermediate %_________________ 15. Year of Pass__________ 16. Marks obtained in Groups :
Maths : ___________ Physics : _________________
Chemistry : _______________
17. Degree % ______________ 18. % of Marks in Groups : _______________________________________
16. Reserve Category _________________________ 17. Is Physically Handicapped ____________________
18. EAMCET / ECET / ICET H.T.No._________________19. EAMCET / ECET / ICET Rank _______________
20. Sports & Extracurricular activities, if any _____________________________________________________
21. Identification Marks 1.____________________________________________________________________
2.___________________________________________________________________
22. Mother’s Name __________________________23. Father’s Name _______________________________
25. Occupation & Office Address ______________________________________________________________
_____________________________________________Office Phone No. _____________________________
24. Telephone No. (Parent) : Land Line (with STD code) ___________________________________________
26. Parent address for Communication _________________________________________________________
_________________________________________________________________________________________
_________________________________________________Mobile No._______________________________
26. Remarks _____________________________________________________________________________
_________________________________________________________________________________________
SIGNATURE OF GUARDIAN
SIGNATURE OF FATHER
SIGNATURE OF MOTHER
DATE :
SIGNATURE OF THE CANDIDATE
FOR OFFICE USE ONLY
Date of admission _____________________ College Roll No. / Hall Ticket No. _______________________
Principal
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